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Biliverdin IXα is a naturally occurring green tetrapyrrolic bile pigment and an intermediate product of heme catabolism. It is generated by the cleavage of heme at the alpha-methane bridge, a reaction catalyzed by the rate-limiting enzyme heme oxygenase (HO-1 and HO-2). Biliverdin IXα is subsequently reduced to bilirubin IXα by the cytosolic enzyme biliverdin reductase A (BLVRA). Biliverdin IXα exhibits potent antioxidant, anti-inflammatory, and cytoprotective properties. In preclinical models, administration of biliverdin IXα has been shown to attenuate angiotensin II-induced hypertension, improve renal hemodynamics, and prevent intimal hyperplasia following vascular injury. Its therapeutic effects are primarily mediated through its conversion to bilirubin, which acts as a scavenger of reactive oxygen species (ROS) and a ligand for peroxisome proliferator-activated receptor alpha (PPARα), as well as through direct signaling via biliverdin reductase to modulate inflammatory pathways such as TLR4 and IL-10.
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